Users In South Africa Research Articles

Healthcare needs and expectations of family members caring for mental healthcare users in South Africa

Background: In South Africa, many mental healthcare users reside in rural areas and 91% of them live with their family members. Exploring and describing the needs of family members caring for mental healthcare users is important to determine their expectations of the healthcare system.Objectives: The study aimed to explore and describe the healthcare needs and expectations of family members caring for mental healthcare users in Vhembe district, Limpopo province, South AfricaMethod: A qualitative, descriptive and contextual design was used to collect data from 16 purposively selected family members caring for mental healthcare users. Data were collected through semi-structured face-to-face interviews, and analysed using thematic data analysis to develop themes and categories.Results: The results of the interviews yielded two themes, healthcare needs and expectations of family members. The needs included physical healthcare, psychological healthcare, and social, financial, educational and spiritual needs. The healthcare expectations were divided into two sub-themes: (1) expectations from the healthcare systems, and (2) expectations from healthcare professionals.Conclusion: The study showed that support from community members and healthcare providers could reduce the burden of care perceived by family members. Results confirmed the need for developing a family psychoeducational programme adapted to the South African context to meet the family members’ needs. Quantitative research on healthcare needs with a larger sample of family members is recommended.Contribution: The study may contribute to mental health nursing practice and education. Nursing support based on the needs of family members may enhance their well-being and caregiving abilities. The importance of tailor-made psychoeducational family support should be emphasised in nursing education.

Preferences for Delivery of HIV Prevention Services Among Healthcare Users in South Africa: A Discrete Choice Experiment.

Progress has been made to scale oral pre-exposure prophylaxis (PrEP) as part of combination HIV prevention, with the WHO recommending differentiated, simplified and demedicalized approaches. This study explored user preferences for components of a PrEP service delivery package, through a discrete choice experiment (DCE) among 307 people accessing primary healthcare services in South Africa between November 2022 and February 2023. Attributes included were: Source of information about HIV prevention and PrEP; Site for PrEP initiation and follow-up; Frequency of follow-up; PrEP pick-up point; HIV testing whilst using PrEP; Contact between appointments. A D-efficient DCE design was created with 16 choice sets in 2 blocks. DCE data were analysed using generalised multinomial logistic models. Compared to printed materials, participants preferred getting information about PrEP online (aOR = 7.73, 95% CI = 5.13-11.66) and through WhatsApp (aOR = 2.23, 95% CI = 0.98-5.55). PrEP initiation at a pharmacy or mobile clinic was valued equally to initiating PrEP at a clinic, but a community pop-up site was less preferred (aOR = 0.46, 95% CI = 0.33-0.64). There was a preference for 6-monthly over 3-monthly follow-up (aOR = 11.88, 95% CI = 5.44-25.94). Participants preferred collecting PrEP from a pharmacy (aOR = 5.02, 95% CI = 3.45-7.31), through home delivery (aOR = 2.18, 95% CI = 1.26-3.78) and from a vending machine (aOR = 1.43, 95% CI = 1.02-1.99) relative to where they initiated PrEP. Participants also preferred HIV self-testing over a healthcare provider test (aOR = 5.57, 95% CI = 3.72, 8.36). WhatsApp or Facebook groups (aOR = 4.12, 95% CI = 3.00-5.67), monthly phone calls (aOR = 2.84, 95% CI = 1.73-4.67) and weekly messages (aOR = 1.47, 95% CI = 1.10-1.97) were preferred contact between appointments, relative to no contact. To meet users' preferences, there is a need to expand decentralised and self-led HIV prevention services.

Mapping SCS hydrological soil groups over South Africa at terrain unit spatial resolution

Given the many users in South Africa of the SCS (Soil Conservation Service) hydrograph-generating technique, which requires key soils information, this paper presents a methodology to develop a detailed map (at the spatial resolution of South Africa's 27 491 terrain units) of the SCS runoff-related soil groups. In order to achieve this objective, background is first provided on the soils context within the SCS technique, as well as on the approaches to defining SCS hydrological soil groups, by assigning SCS soil groups to South African soil series. Steps when mapping SCS soil groups across South Africa at terrain unit spatial resolution are then outlined. This is followed by the presentation and interpretation of the detailed terrain unit level map of SCS soil groups for South Africa. The detailed new map illustrates the finer detail across contributing catchments countrywide now obtained from the terrain unit approach, compared to the previous map of SCS soil groups based only on the coarser soil land types.

The new normal: the adoption of food delivery apps

PurposeIn the wake of lockdown regulations and limited mobility during the COVID-19 pandemic, dining habits shifted towards usage of food delivery apps to avoid physical interaction. Nonetheless, it is unknown whether the COVID-19 pandemic had an influence on the adoption of food delivery apps. Therefore, this study examined factors influencing the adoption of food delivery apps during the COVID-19 pandemic, as well as the moderating effects of education and age.Design/methodology/approachData were collected from 282 food delivery application users in South Africa using a web-based survey. Partial least square structural equation modelling analysis was used to test the hypotheses, while partial least squares multigroup analysis was used to examine the moderating effect of education level and age.FindingsThe results indicated that perceived ease of use has a significant impact on perceived usefulness and attitudes, perceived usefulness has an impact on attitudes and continuous intention, attitude influences continuous intention and social pressure and convenience influence attitudes. The perceived COVID-19 threat had no impact on attitudes, and education and age had no significant impact on any relationships. The findings are imperative for restaurants and mobile application designers, as they enable more effective strategic management planning.Originality/valueThis study is the first paper to empirically employ technology acceptance model to analyse the adoption of food delivery applications during the COVID-19 pandemic. Its uniqueness is in examining situational influence associated with the pandemic such as social pressure, perceived COVID-19 threat and convenience.

Mental Health Needs of Adolescent and Young Adult PrEP Users in South Africa: Implications for Sexual and Reproductive Health Programming

PurposePoor mental health is associated with sexual and reproductive health (SRH) risks, including human immunodeficiency virus (HIV) and pre-exposure prophylaxis discontinuation. Adolescents and young people (AYP) are vulnerable to HIV and depression. This paper describes the prevalence and severity of depression and associated factors in AYP accessing SRH services in South Africa. MethodsA cross-sectional analysis of enrollment data (January 2019 to December 2021) from a cohort of individuals receiving pre-exposure prophylaxis services at eight clinics in three provinces in South Africa was conducted. Females (n = 1,074) and males (n = 231) aged 15–24 years were included. Interviewer-administered questionnaires were conducted, and the prevalence and severity of depression assessed using the Patient Health Questionnaire-9. Multivariate analysis was used to identify factors associated with depression. ResultsOver 40% of participants had experienced any depression symptoms (43.7% of females, 38.5% of males). For males, experiencing intimate partner violence was the only predictor of depression symptoms (adjusted odds ratio (AOR) 8.81, 95% confidence intervals (CI) 1.03–75.44). For females, living with both parents (AOR 1.70, 95% CI 1.15–2.51), having transactional sex (AOR 1.63, 95% CI 1.00–2.65), experiencing any intimate partner violence (AOR 1.96, 95% CI 1.34–2.89), and using drugs (AOR 1.78, 95% CI 1.03–3.11) were all positively associated with depression symptoms. Resilience was a protective factor against depression symptoms for both sexes (males: AOR 0.96, 95% CI 0.93–0.98; females: AOR 0.96, 95% CI 0.95–0.97). DiscussionThere is a high burden of depression among AYP accessing SRH services in South Africa. Mental health screening should be integrated into SRH and HIV prevention programs for AYP.

Revisiting marine services pricing in South Africa’s ports

Transnet National Ports Authority (TNPA) is the landlord and sole provider of marine services in South Africa’s eight commercial ports. Historically, TNPA set port prices for marine (nautical) services below full cost recovery. Price regulation has improved the situation, but substantial reforms are still required. This paper revisits marine services pricing in South Africa’s ports. The methodology employed content analysis to analyse 99 stakeholders’ submissions to the Ports Regulator of South Africa from financial years 2013/2014 to 2021/2022. The results are discussed under four categories of themes: concerns about the above-inflation price increase, suggestions on alternative marine services pricing models, concerns about marine services provision and productivity, and the disputed cross-subsidization between ports and port user groups. Despite above-inflation price increases for marine services, tariffs remain 44% below the global benchmarked mean, whilst revenues from cargo owners subsidise port tenants and shipping lines. The relatively low prices for marine services may exacerbate the sub-optimal levels of investment and maintenance in marine services. The study recommends that marine services pricing reforms incorporate the user-pays principle, be founded on activity-based costing, and adopt a dual-till model. Activity-based costing is considered the international best practice, and it is the preferable approach recommended by several port users in South Africa.

A qualitative study to explore strategies to improve the Road to Health Application for maternal and child health outcomes in South Africa.

The Road to Health Application (RTHA) is essentially a digitalized version of the National Department of Health's Road to Health book, and a hand-printed booklet given to mothers at the birth of each baby. The RTHA, like the booklet, provides guidelines for maternal and child health outcomes, with the goal of creating a database of children and caregivers in South Africa and teaching them how to raise a healthy child. This paper explored potential barriers and enablers to using the RTHA in the South African context based on user experiences. Using a qualitative design, we conducted 50 serial interviews (two separate interviews, 1 month apart). Through convenience, sampling eligible participants were 18 years or older women who were pregnant and/or had a child under the age of 5 years. Participants included 25 existing users and 25 new users of the RTHA, who owned android smart phones at enrollment. Existing users were recruited telephonically through the National Department of Health database, and new users were approached at the antenatal care unit and wellness baby clinic (women with children under 5 years) at the Chris Hani Baragwaneth Academic Hospital. Upon enrollment, participants completed a brief survey on sociodemographics and mobile phone use, and thereafter, they had a baseline interview followed by a telephonic interview 1 month later. A semistructured interview guide was used to explore barriers, enablers, and the usability of the RTHA. Using thematic data analysis, we identified enablers and barriers to the use of the RTHA. A third (33%) of all participants reported IsiZulu as their main language of communication, and 6% of the participants reported English as their main language of communication. The RTHA was an important addition to the booklet that helped keep new mothers informed about child immunization and provided important information about healthy child rearing practices. However, multiple barriers were cited to using the RTHA; these included the fact that the app was only available in two languages, high data costs, lack of access to smart phones, and app functionalities. The enablers to using the RTHA included the accessibility of important information regarding prenatal and postnatal childcare. This study gives insight into the barriers and enablers from the end-user perspective to improve the RTHA for future use in South Africa and offers guidance on how to improve the RTHA to be more user-friendly, which could increase its usability among mothers. It further emphasizes the need to consider the challenges experienced by users in South Africa when developing future mobile health interventions to increase uptake.

Self-reported Vocal Demands, Perceptions, and Knowledge of Occupational Voice Users in South Africa

The study aimed to describe daily vocal demands, perceptions and knowledge as reported by occupational voice users. A descriptive, cross-sectional research design was employed. A survey on vocal demands, perceptions and knowledge was distributed to 102 occupational voice users via a snowball sampling technique. Slightly more than half of the participants (55%) reported using their voice for work 36.5 hours a week on average (SD=15.5, range: 33-40). Participants reported that, on average, their daily voice use is 6.3 hours (SD=2.7) for work and the majority (81%) reported a decrease in voice quality after work; Three-quarters (75%) also reported vocal fatigue at the end of day. Approximately one-third (33%) reported being exposed to environments where they are expected to shout, scream or cheer loudly. More than half of the participants (61%) reported that they have previously received vocal health education but 40% reported that they felt this training was insufficient. High vocal demands are significantly correlated to an increase in perceived vocal handicap rs=0.242; (P = 0.018), tiredness of voice rs=0.270; (P = 0.008), physical discomfort rs=0.217; (P = 0.038) as well as how occupational voice users experience improvement of symptoms with rest rs=-0.356 (P < 0.001). Other risk factors highlighted by occupational voice users are the ingestion of liquid caffeine, alcohol, and carbonated drinks, smoking or the presence of chronic cough, chronic laryngitis, and gastroesophageal reflux disease. Occupational voice users are subjected to high daily vocal demands that can be seen to be linked to vocal fatigue, changes in voice quality and vocal symptoms experienced. It is essential that occupational voice users as well as treating clinicians are aware of certain significant predictors of both vocal handicap and vocal fatigue. These findings provide insights for developing strategies for training and cultivating vocal health consciousness and preventive voice care initiatives that focus on occupational voice users in South Africa.

End-user research in support of long-acting systemic antiretroviral delivery systems: insights from qualitative research with providers and target users in South Africa

While oral pre-exposure prophylaxis (PrEP) has been shown to reduce the risk of HIV, challenges such as adhering to a daily-dosing regimen and persistence have emerged as barriers for at-risks populations in South Africa. This qualitative research sought to investigate perceptions of and preferences for a long-acting, biodegradable implantable PrEP product designed to address these barriers. To identify and understand motivators, barriers, and preferences for the PrEP implant, we conducted qualitative in-depth interviews (IDIs) among health care providers (HCPs) and target end-users (young women, adolescent girls, and female sex workers) in urban and rural/peri-urban regions of Gauteng Province, South Africa. The IDIs focused on defining values, beliefs, habits, lifestyles, influencers, and information channels for potential PrEP implant end-users. We conducted 36 IDIs across health care providers and target end-user respondent segments. Respondents had generally positive reactions to the PrEP implant. Most end-users felt that some undesirable aspects of the implant (e.g., side effects, pain during insertion, potential scarring, and inability to removeimplant) would be offset by having a highly effective, and long-lasting HIV prevention product. Although some HCPs believed the implantable PrEP would lead to increases in promiscuity and risky sexual behavior, most HCPs saw value in the PrEP implant's long duration of protection, its biodegradability, and the likelihood of higher adherence relative to oral PrEP. This study is a first step toward further research needed to demonstrate the demand for a biodegradable, long-acting implantable PrEP and suggests such a product would be accepted by end-users and HCPs in South Africa. This study indicates the need to develop more convenient, discreet, long-acting, and highly effective biomedical HIV prevention options for at-risk populations.

Factors influencing quality and performance of cloud computing platforms defined by personal users in South Africa

Cloud computing changed our way of doing things because we now maintain our systems and data on global online platforms. The research aimed to investigate the predictive factors determining the quality of personal users' cloud computing and their effect on platform performance. The study adopted a cross-sectional, descriptive, quantitative design conducted within South African communities and received 254 responses, a response rate of 66.1%. The measurement model (SRMR = 0.071) results demonstrated that cost-effectiveness, reliability, flexibility, availability, security effectiveness, and scalability collectively define the quality of cloud computing platforms utilized by personal users. AVE (0.575 – 0.694), CR (0.844 – 0.901), Fornell-Larcker criterion, and cross-loadings confirmed convergent validity, reliability, and discriminant validity. Security effectiveness, scalability, and reliability have a statistically significant effect on platform performance with small to medium effect sizes. The theoretical implication is an enhanced domestication theory of technology based on cloud computing, thus providing insights into the needs required to fit within the prevailing environment and context. In addition, it helped understand the personal users' decisions on cloud computing. The study enhances cloud computing at a personal level through understanding that the decision and value may differ from well-researched organizational levels.

Metanarratives of visual impairment rehabilitation: the discursive positioning of disabled service users in South Africa

This paper presents findings from a study on blindness discourses found in South African non-profit organisations that provide rehabilitation services to visually impaired adults. The paper investigates what the public relations materials of these organisations communicate about blindness. It also considers the ideological assumptions that blindness discourses reinforce and embed in rehabilitation practice. The primary focus is a discourse analytic review conducted on a sample of organisation public facing material. The findings comprise three clusters of assumptions, with concomitant enactments in practice. These are i) third-person alliances around the blind subject and a resulting objectification of service users ii) ‘journey discourse’ which prohibits the expression of complex disability experiences and iii) polarised blindness fantasies which promote othering and prescribe acceptable ways of being for blind subjects. This paper questions what might be imparted to blind persons at a symbolic level through rehabilitative practices.

Components of the Mobile Social Networking Sites Addiction Scale and Its Relationship with Social Overload and Religiosity

The present study aims at adapting and validating the Bergen Facebook Addiction Scale (BFAS) for mobile social networking site (MSNS) addiction in the context of a developing country. The study further examines the role of social overload and religiosity in MSNS addiction. A cross-sectional survey was used to obtain data from a sample of 557 MSNS users in South Africa. The psychometric properties of the adaptation of the BFAS for MSNS addiction were robustly assessed using the structural equation modelling technique. The results suggest a five-factor addiction component model for MSNS addiction with excellent psychometric properties. Given that much of the existing literature suggests a six-factor behavioural addiction component model for SNS addiction, the findings of the present study contribute new insights into the literature and reinforce the need for far-reaching cross-cultural validation scales beyond their original contexts. Furthermore, the findings of the study make an original contribution to the literature by explaining how social overload mediates the impact of religiosity on users who are addicted to MSNS.

Advancing cybersecurity capabilities for South African organisations through R&amp;D

There is a growth of cyber-attacks in South Africa. Seeing that there are over 38 million Internet users in South Africa, this is no surprise. The South African government has published the National Cybersecurity Policy Framework (NCPF) and Protection of Personal Information Act (POPIA) to move towards mitigating cyber threats due to the increase of the presence of South African organisations and citizens in cyber space. This demonstrates that there is a need for organisations to have a clear roadmap to implement and improve on their own cybersecurity capabilities. South African organisations need to take a proactive stance in cybersecurity because businesses rely heavily on technology for day-to-day operations. Currently cyber-attacks cost South African organisations over R2 billion, and the current work-from-home arrangement that most organisations have implemented will only worsen the situation. While a cybersecurity roadmap will differ in every organisation based on the organisation’s vision, goals, and objectives, along with their information technology (IT) and operations technology (OT), a starting point is perhaps the identification of key research and development (R&amp;D) areas together with key activitiesthat organisations can focus on in order to improve their cybersecurity capabilities. Cybersecurity capabilities are tools that organisations use to strengthen their organisation and protect themselves from potential cyber threats. The purpose of this study was to investigate R&amp;D areas that organisations should invest in for the purpose of improving their cybersecurity capabilities. There are various subfields in cybersecurity that can be explored for organisations to advance their cybersecurity capabilities. Five integral R&amp;D dimensions were identified together with key activities and are presented and discussed. A conceptual framework is also presented which maps the R&amp;D dimensions and activities to the main pillars of cybersecurity, i.e., People, Processes, and Technology. South African organisations could reference the framework and adapt it for their business needs to protect themselves against potential cyber threats.

Fatality risk and issues of inequity among vulnerable road users in South Africa.

BackgroundContextual effects from the physical and social environment contribute to inequitable protection for a large proportion of road users, especially in low- and middle-income countries like South Africa where distorted urban planning and socio-spatial disparities from the apartheid era prevail.ObjectivesThis paper examines the differentiated risk of road traffic crashes and injuries to vulnerable road users in South Africa, including pedestrians, females and users of some modes of public transport, in relation to characteristics of the crashes that proxy a range of contextual influences such as rurality and socio-economic deprivation.MethodsThe study is based on a descriptive analysis of 33 659 fatal crashes that occurred in South Africa over a three-year period from 2016–2018. Measures of simple proportion, population-based fatality rate, “impact factor” and crash severity are compared between disaggregated groups using Chi-Square analysis, with the Cramer’s V statistic used to assess effect size.Results and significanceKey findings show a higher pedestrian risk in relation to public transport vehicles and area-level influences such as the nature of roads or extent of urbanity; higher passenger risk in relation to public transport vehicles and rurality; and higher risk for female road users in relation to public transport vehicles. The findings have implications for prioritising a range of deprivation-related structural effects. In addition, we present a “User-System-Context” conceptual framework that allows for a holistic approach to addressing vulnerability in the transport system. The findings provide an important avenue for addressing the persistently large burden of road traffic crashes and injuries in the country.

Measuring quality of pre-hospital traumatic shock care-development and validation of an instrument for resource-limited settings.

Background and AimsImproving the quality of pre‐hospital traumatic shock care, especially in low‐ and middle‐income countries, is particularly relevant to reducing the large global burden of disease from injury. What clinical interventions represent high‐quality care is an actively evolving field and often dependent on the specific injury pattern. A key component of improving the quality of care is having a consistent way to assess and measure the quality of shock care in the pre‐hospital setting. The objective of this study was to develop and validate a chart abstraction instrument to measure the quality of trauma care in a resource‐limited, pre‐hospital emergency care setting.MethodsTraumatic shock was selected as the tracer condition. The pre‐hospital quality of traumatic shock care (QTSC) instrument was developed and validated in three phases. A content development phase utilized a rapid literature review and expert consensus to yield the contents of the draft instrument. In the instrument validation phase, the QTSC instrument was created and underwent end user and content validation. A pilot‐testing phase collected user feedback and performance characteristics to iteratively refine draft versions into a final instrument. Accuracy and inter‐ and intra‐rater agreement were calculated.ResultsThe final QTSC instrument contains 10 domains of quality, each with specific criteria that determine how the domain is measured and the level of quality of care rendered. The instrument is over 90% accurate and has good inter‐ and intra‐rater reliability when used by trained pre‐hospital provider users in South Africa. Pre‐hospital provider user feedback indicates the tool is easy to learn and quick to use.ConclusionWe created and validated a novel chart abstraction instrument that can reliably and accurately measure the quality of pre‐hospital traumatic shock care. We provide a systematic methodology for developing and validating a quality of care tool for resource‐limited care settings.

Mental health stigma experiences among caregivers and service users in South Africa: a qualitative investigation.

The study aimed to understand the nature and context of mental health stigma among people living with a mental health condition and the subsequent effect on their caregivers. Semi-structured qualitative face to face interviews were conducted by trained mental healthcare professionals with mental health service users (n = 26) and caregivers (n = 24) in private rooms at a tertiary health facility, where service users were admitted. Following transcription and translation, data was analysed using framework analysis. There was limited knowledge about their mental health diagnosis by service users and generally low mental health literacy among service users and caregivers. Mental health service users reported experiences of stigma from their own families and communities. Caregivers reported withholding the patient’s diagnosis from the community for fear of being stigmatised, and this fear of stigma carries the risk of negatively affecting care treatment-seeking. Limited mental health knowledge, coupled with a high prevalence of perceived family and community stigma among caregivers and service users, impedes the capacity of caregivers to effectively cope in supporting their family members living with mental illness. There is a need for interventions to provide psychoeducation, reduce community stigma, and support coping strategies for caregivers and people with mental health conditions.

Evaluation of an Advocacy Programme for Mental Health Care Users in South Africa: A Mixed Methods Study

This study evaluates the implementation of a national advocacy programme for mental health care users, conducted by the South African National Department of Health and the South African Federation for Mental Health. Semi-structured interviews were conducted with care users (n = 18), service providers (n = 9), support persons (n = 6), NGO directors (n = 4), and programme managers in the DoH (n = 4). Although informational benefits were highlighted from programmeempowerment sessions, very few advocacy groups were subsequentlyestablished. Barriers to establishing and conducting advocacy groups included a lack of follow-up support, pervasive stigma from communities and health care workers, low self-confidence, and a lack of financial resources. Facilitators for establishment of groups included conducting empowerment sessions and identifying 'mental health champions' at clinics, improving mental health training for health workers, dispensing psychiatric medication to patients on the same day, providing funding for non-governmental organisations, conducting national awareness campaigns, and establishing holistic rehabilitation centres for care users.

Prevalence and Incidence of Sexually Transmitted Infection in Injectable Progestin Contraception Users in South Africa.

Introduction:Whether intramuscular depot medroxyprogesterone acetate (DMPA-IM) and norethisterone enanthate (NET-EN) have a differential impact on the incidence of sexually transmitted infection (STI) remains unclear. In the Vaginal and Oral Interventions to Control the Epidemic (VOICE) trial, HIV-1 acquisition was higher for DMPA-IM users vs. NET-EN users. We compared DMPA-IM and NET-EN users with regard to chlamydia, gonorrhea, trichomoniasis, syphilis, and herpes simplex virus type 2 (HSV-2) infection.Materials and Methods:Prospective data were analyzed from VOICE, a randomized trial of HIV-1 chemoprophylaxis. Participants were evaluated annually and as indicated for chlamydia, gonorrhea, trichomoniasis, and syphilis. Stored specimens were tested for HSV-2. Proportional hazards models compared the risk of STI between DMPA-IM and NET-EN users.Results:Among 2,911 injectable contraception users in South Africa, 1,800 (61.8%) used DMPA-IM and 1,111 used NET-EN (38.2%). DMPA-IM and NET-EN users did not differ in baseline chlamydia: 15.1 vs. 14.3%, p= 0.54; gonorrhea: 3.4 vs. 3.7%, p= 0.70; trichomoniasis: 5.7 vs.5.0%, p= 0.40; or syphilis: 1.5 vs. 0.7%, p= 0.08; but differed for baseline HSV-2: (51.3 vs. 38.6%, p < 0.001). Four hundred forty-eight incident chlamydia, 103 gonorrhea, 150 trichomonas, 17 syphilis, and 48 HSV-2 infections were detected over 2,742, 2,742, 2,783, 2,945, and 756 person-years (py), respectively (chlamydia 16.3/100 py; gonorrhea 3.8/100 py; trichomoniasis 5.4/100 py; syphilis 0.6/100 py; HSV-2 6.4/100 py). Comparing DMPA-IM with NET-EN users, no difference was noted in the incidence of chlamydia, gonorrhea, trichomoniasis, syphilis, or HSV2 infections, including when adjusted for confounders [chlamydia (aHR 1.03, 95% CI 0.85–1.25), gonorrhea (aHR 0.88, 95% CI 0.60–1.31), trichomoniasis (aHR 1.07, 95% CI 0.74–1.54), syphilis (aHR 0.41, 95% CI 0.15–1.10), and HSV-2 (aHR 0.83, 95% CI 0.45–1.54, p= 0.56)].Discussion:Among South African participants enrolled in VOICE, DMPA-IM and NETEN users differed in prevalence of HSV-2 at baseline but did not differ in the incidence of chlamydia, gonorrhea, trichomoniasis, syphilis, or HSV-2 infection. Differential HIV-1 acquisition, previously demonstrated in this cohort, does not appear to be explained by differential STI acquisition. However, the high incidence of multiple STIs reinforces the need to accelerate access to comprehensive sexual and reproductive health services.

Modeling Mobile Commerce Applications’ Antecedents of Customer Satisfaction among Millennials: An Extended TAM Perspective

The continued growth for both smartphone usage and mobile applications (apps) innovations has resulted in businesses realizing the potential of this growth in usage. Hence, the study investigates the antecedents of customer satisfaction due the usage of mobile commerce (m-commerce) applications (MCA) by Millennial consumers in South Africa. The conceptual model antecedents were derived from the extended Technology Acceptance Model (TAM). The research made use of self-administered questionnaires to take a cross section of Millennial MCA users in South Africa. The sample comprised of nearly 5500 respondents and the data was analyzed via structural equation and generalized linear modeling. The results revealed that trust, social influence, and innovativeness positively influenced perceived usefulness; perceived enjoyment, mobility, and involvement positively influenced perceived ease of use; and perceived usefulness and perceived ease of use were positive antecedents of customer satisfaction. Several usage and demographic characteristics were also found to have a positive effect on customer satisfaction. It is important for businesses to improve customer experience and satisfaction via MCA to facilitate a positive satisfaction and social influence among young technologically savvy consumers.

An assessment of voting knowledge and related decisions amongst hospitalised mental healthcare users in South Africa.

BackgroundThe South African Constitution protects the right to vote for every citizen. The Electoral Act (No. 73 of 1998) limits registration on the voter’s roll on the basis of being declared of ‘unsound mind’ or ‘mentally disordered’ by the high court or detention under the Mental Health Care Act (No. 17 of 2002). There is limited information regarding voting knowledge and subsequent voting-related decisions amongst South African involuntary mental healthcare users (MHCUs).AimTo compare voting knowledge and related decisions between hospitalised MHCUs and non-psychiatric hospitalised patients (controls).SettingParticipants were recruited from Sterkfontein Psychiatric Hospital (MHCUs) and Chris Hani Baragawanth Academic Hospital orthopaedic wards (controls) in Gauteng, South Africa.MethodA cross-sectional survey was conducted using a modified Cognitive Assessment Tool for Voting (MCAT-V) questionnaire. Scores on the MCAT-V were compared between the MHCU and control groups, along with socio-demographic variables and clinical variables.ResultsThere was a significant association between group (MHCU vs. control) and HLOE (p = 0.016). Although the median overall score for the controls (11; interquartile range [IQR] 10–12) was significantly higher than that for the MHCUs (10; IQR 8–12) (p = 0.043), when controlling for education level, there was no significant association between group (MHCU/control) and MCAT-V scores (p = 0.011). The MCAT-V scores of the ‘Doe questions’ between the MHCUs and controls were not significantly different (p = 0.063). There was a difference in ‘reasoning scores’ between MHCUs and controls (p = 0.0082) and this was associated with level of educational attainment (p = 0.013).ConclusionThe limitations regarding voter registration legislated in the South African Electoral Act, are not supported by the findings of this study. The MCAT-V demonstrates a possible educational bias and therefore is not recommended as a screening tool for assessing voting competency.